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Leptin and the risk of Barrett's oesophagus.
  1. Bradley J Kendall (bradkendall{at}hotmail.com)
  1. QIMR, Australia
    1. Graeme A Macdonald
    1. University of Queensland, Australia
      1. Nicholas K Hayward
      1. QIMR, Australia
        1. John B Prins
        1. University of Queensland, Australia
          1. Ian Brown
          1. Sullivan and Nicolaides Pathology, Australia
            1. Neal Walker
            1. Queensland Medical Laboratories, Australia
              1. Nirmala Pandeya
              1. QIMR, Australia
                1. Adele C Green
                1. QIMR, Australia
                  1. Penelope M Webb
                  1. QIMR, Australia
                    1. David C Whiteman (david.whiteman{at}qimr.edu.au)
                    1. QIMR, Australia

                      Abstract

                      Background: Obesity is associated with increased risks of Barrett’s oesophagus (BO) and oesophageal adenocarcinoma (OA). Alterations in serum leptin and adiponectin, obesity-related cytokines, have been linked with several cancers, and have been postulated as potential mediators of obesity-related carcinogenesis, however the relationship with BO remains unexplored.

                      Methods: We measured serum leptin and adiponectin concentrations on two subsets of participants within a case-control study conducted in Brisbane, Australia. Cases were people aged 18-79 years with histologically confirmed BO newly diagnosed between 2003-2006. Population controls, frequency matched by age and sex to cases, were randomly selected from the electoral roll. Phenotype and medical history data were collected through structured, self-completed questionnaires. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression analysis.

                      Results: In the pilot analysis (51 cases, 67 controls) risks of BO were highest among those in the highest quartile of serum leptin (OR 4.6, 95% CI 0.6-33.4). No association was seen with adiponectin. In the leptin validation study (306 cases, 309 controls), there was a significant three-fold increased risk of BO among males in the highest quartile of serum leptin (OR 3.3, 95% CI 1.7-6.6) and this persisted after further adjustment for symptoms of gastro-oesophageal reflux (OR 2.4, 95% CI 1.1-5.2). In contrast, the risk of BO among females decreased with increasing serum leptin concentrations.

                      Conclusions: High serum leptin is associated with increased risk of BO among males but not females. This association is not explained simply by higher body mass or gastro-oesophageal reflux among cases. The mechanism remains to be determined.

                      • Barrett's oesophagus
                      • Oesophageal cancer
                      • case-control study
                      • obesity
                      • risk factors

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                      • competing interests 57/4/448

                        Competing interests: B J Kendall has provided educational programme advice to Johnson and Johnson for which he received remuneration.

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